Type 2 Diabetes Remission After Roux-en-Y Gastric Bypass: Evidence for Increased Expression of Jejunal Genes Encoding Regenerating Pancreatic Islet-Derived Proteins as a Potential Mechanism

Obes Surg. 2017 Apr;27(4):1123-1127. doi: 10.1007/s11695-017-2602-0.

Abstract

Background: Intestinal expression of regenerating pancreatic islet-derived protein-encoding genes (REG) would be enhanced after Roux-en-Y gastric bypass (RYGB) and would affect postoperative type 2 diabetes remission (T2Dr).

Methods: Intestinal biopsy samples were collected from 20 adult obese women with T2D before and 3 months after RYGB. Levels of REG expression and the gene encoding its putative receptor (EXTL3) were assessed by microarray and validated by quantitative RT-PCR. T2Dr was assessed according to ADA criteria 1 year after RYGB.

Results: After RYGB, only patients with T2Dr had significantly increased REG1α and REG3γ expression in the jejunum, as validated by quantitative RT-PCR.

Conclusions: Our data provide support for the hypothesis that increased jejunal expression of REG genes after RYGB affects T2Dr, possibly by playing an endocrine function.

Trial registration: ClinicalTrials.gov NCT01251016.

Keywords: Gene expression; Glycemic control; Regeneration genes; Roux-en-Y gastric bypass; Type 2 diabetes mellitus.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Biopsy
  • Diabetes Mellitus, Type 2 / genetics
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / surgery*
  • Female
  • Gastric Bypass / methods*
  • Gene Expression Profiling / methods
  • Gene Expression Regulation
  • Humans
  • Intestine, Small / metabolism
  • Intestine, Small / pathology
  • Islets of Langerhans / metabolism
  • Jejunum / metabolism*
  • Middle Aged
  • Obesity / metabolism
  • Obesity / pathology
  • Obesity / surgery*
  • Obesity, Morbid / metabolism
  • Obesity, Morbid / pathology
  • Obesity, Morbid / surgery
  • Pancreatitis-Associated Proteins / biosynthesis
  • Pancreatitis-Associated Proteins / genetics*
  • Pancreatitis-Associated Proteins / physiology
  • Remission Induction
  • Young Adult

Substances

  • Pancreatitis-Associated Proteins

Associated data

  • ClinicalTrials.gov/NCT01251016